Abstract

Introduction: Although TB notification rate declined significantly in the last 8 years in Romania, from 142.2%ooo in 2002 to 90.5%ooo in 2010, MDR-TB cases still need a special attention (812 such cases have been reported in 2009). The DOTS Plus project funded by Global Fund and started in Romania in December 2004 has as purpose to provide high quality health services to a part of MDR-TB patients in Romania.

Methods: In the retrospective study have been enrolled 794 MDR-TB cases registered in DOTS Plus project between December 2004 and December 2010. Data have been collected from database of the project and National TB Register.

Results: From the total of 794 cases registered in the project and hospitalized in the 2 MDR-TB excellence centers in the country (57.5% in Bucharest and 42.5% in Bisericani), 67.7% were males and 32.3% females. Primary MDR was found in 26.6% of the cases. The DST pointed 49.3% with only HR resistance and 50.7% with other drug resistances (HR+1 to HR+5). 13 cases had XDR-TB. The ambulatory phase of the treatment was done at 119 TB dispensaries (62% from all TB dispensaries countrywide). The default rate decreased obviously from 31.5% in 2006 to 12.9% in 2008, consecutive to the distribution of different kind of incentives which improved treatment adherence. Success rate of the GLC patients (62%) was significantly higher then at the patients treated with NTP resources (24.2%).

Conclusions: The favorable evolution of MDR-TB patients enrolled in DOTS Plus project demonstrates real benefits and recommend its case MDR management extension to all MDR-TB cases in the country.